Plaque psoriasis is the most common type of psoriasis. It is characterized by patches of skin covered in silvery scales. These plaques can be itchy and sometimes painful.

Psoriasis is a long-term inflammatory condition that results from a problem with the body’s immune system. Skin changes and other symptoms can occur, but treatment can help manage it.

There are several types of psoriasis, but plaque psoriasis is the most common. Plaque psoriasis involves an overgrowth of skin cells, leading to skin patches covered with silvery scales. The patches, or plaques, can be itchy and painful.

The plaques have a well-defined edge and can appear almost anywhere on the body, but they typically affect the scalp, knees, elbows, and lower back.

The symptoms tend to come and go, worsening during a flare and improving or disappearing during remission.

Here are some pictures of plaque psoriasis symptoms:

Plaque psoriasis can feature:

  • plaques of skin with well-defined edges
  • itching, cracking, and bleeding of skin
  • thick, ridged, and pitted nails

On lighter skin, the lesions may be pink. On darker skin, the plaques may be darker than the surrounding skin. Heavy white or silvery scales often cover the surface of the plaques.

Psoriasis plaques can occur anywhere on the body but are most likely to appear on the elbows, knees, lower back, and scalp.

Some people may also experience psoriatic arthritis, which involves pain and inflammation in the joints and other symptoms.

A flare-up is when symptoms of psoriasis appear or worsen. A flare-up can last for several weeks or months. Between flares, the symptoms may improve or disappear. This is called remission. This cycle tends to repeat itself.

How does psoriasis affect darker skin tones?

Scientists do not know what exactly causes psoriasis, but genetic and immune factors appear to play a role.

Genetic factors

People with psoriasis may have specific genetic features that predispose them to the disease.

Psoriasis can run in families, but not everyone with these genetic features develops psoriasis.

The relevant genetic features may increase a person’s risk of developing symptoms in certain circumstances, however. An infection, for example, may trigger psoriasis in a person who has a genetic predisposition.

Environmental triggers

A person can have genetic features that make them susceptible to psoriasis but not develop the condition. Nevertheless, exposure to certain triggers can cause symptoms to appear.

Possible triggers include:

  • stress
  • injury to the skin
  • certain medications
  • infections and other illness
  • weather changes

Some people also report that alcohol use, allergies, and dietary factors affect their psoriasis.

Some of these circumstances or factors can trigger the start of psoriasis but also a flare-up.

What are some psoriasis triggers?

Comorbidities

Psoriasis is a multisystem disease that can affect many aspects of a person’s life and health.

People with plaque and other types of psoriasis are also more likely to experience:

Current guidelines recommend people with psoriasis have regular screening for diabetes, lipid levels, and other health measures that may indicate cardiovascular or other health problems.

Does psoriasis spread?

Doctors sometimes misdiagnose plaque psoriasis because the symptoms may resemble those of other conditions, including:

In the case of seborrheic dermatitis and psoriasis, there is a disorder known as sebopsoriasis that overlaps with both.

Which other conditions look like plaque psoriasis?

A doctor can usually diagnose plaque psoriasis by looking at the skin and nails and examining someone’s medical history.

Sometimes, a doctor will use a skin biopsy to confirm a diagnosis. They will take a small sample of skin to examine under a microscope. This procedure can help rule out other conditions.

Which tests can help diagnose psoriasis?

Anyone who notices unusual changes in their skin should see a doctor.

Individuals with a diagnosis of psoriasis should follow their treatment plan and see their doctor if symptoms persist or worsen or if treatment results in adverse effects.

There is currently no cure for plaque psoriasis, but many treatment options are available, depending on the individual and the severity of symptoms.

Options include:

  • topical treatments, including ointments, creams, and shampoos to relieve skin symptoms
  • light therapy to relieve skin symptoms and possibly prevent flares
  • laser therapy that targets specific skin patches
  • corticosteroid injections to reduce severe inflammation
  • systemic therapy
  • biologic drugs
  • lifestyle choices

Most people with mild symptoms can treat psoriasis at home with topical treatments.

Topical treatments

Topical treatments are often the first choice for managing plaque psoriasis.

Ingredients in topical treatments include:

Applying creams and ointments that contain one or more of these ingredients can:

  • reduce inflammation
  • slow skin cell growth
  • soothe the skin
  • reduce dryness and cracking
  • improve itching

It is best to check first with a doctor or pharmacist before choosing a topical treatment, as some may suit an individual better than others. In certain cases, there may not be enough scientific evidence to confirm that they are safe to use or that they work.

Systemic treatments

Some oral or injected medications that affect the whole body may help treat moderate to severe plaque psoriasis.

Examples of these systemic medications include:

  • cyclosporine
  • acitretin
  • methotrexate

The impact of a systemic therapy will depend on the therapy, but the effects are likely to include reducing inflammation and changing how the immune system works. A doctor will monitor for any adverse effects that may occur.

Biologics

These drugs affect the immune system and target the underlying cause of psoriasis. A range of biologics is available on prescription.

A doctor may prescribe one of these drugs if a person has moderate to severe symptoms of plaque psoriasis.

Phototherapy

Phototherapy uses natural or artificial light to reduce symptoms.

Options include:

Is light therapy effective for psoriasis?

Various home remedies may help manage psoriasis.

Skin-care tips include:

  • Taking a short bath or shower every day in warm but not hot water.
  • Using coal tar or hypoallergenic products as a doctor or pharmacist recommends.
  • Washing gently with the hands rather than scrubbing with a sponge to avoid irritation.
  • Moisturizing with a thick hypoallergenic emollient within 5 minutes of bathing.
  • Applying wet wraps with medication or moisturizers in them.

Other lifestyle tips include:

People with psoriasis often have low vitamin D levels. While controlled sun exposure may improve symptoms, there is not enough evidence to support the use of vitamin D supplements for psoriasis.

A 2018 study noted that using the following complementary or alternative remedies may help:

People should speak with their doctor first before trying any of these.

Can CBD oils help manage psoriasis?

The experience of plaque psoriasis varies widely between individuals. There is no way to predict how long a flare-up or a remission will last, or how severe symptoms will be.

Plaque psoriasis is not a life-threatening condition, but it can severely impact a person’s quality of life. A person with this condition may also have a higher risk of psoriatic arthritis, metabolic disorder, and other conditions.

In some cases, pustular psoriasis can develop, which can be life-threatening.

However, there are many ways to manage plaque psoriasis, and some medications can now help reduce the frequency and severity of symptoms.

Here are some questions people often ask about plaque psoriasis.

How do you reduce scaling on plaque psoriasis?

Emollient creams may help reduce roughness, itching, and dryness in plaque psoriasis.

The author of a 2022 study suggested that it may help to apply an over-the-counter gel containing turmeric and salicylic acid once a day, followed by an exfoliating moisturizer containing shea butter and salicylic acid.

Avoid the temptation to scrape off the scale, as this may open the skin to infection and more discomfort.

What causes plaque psoriasis?

Experts do not know exactly why plaque psoriasis happens, but it appears to happen when a faulty immune response causes skin cells to grow too quickly.

Genetic and environmental factors probably contribute. For people with a genetic susceptibility, smoking, stress, infections, and other factors can trigger it.

What are the signs and symptoms of plaque psoriasis?

Skin changes include the appearance of raised, silvery patches on the skin that may be pink on some skin tones. The patches may be painful and itchy, and they may crack and bleed.

Plaque psoriasis is a common condition that people can often manage with topical treatments. If symptoms persist or become severe, other treatments are available that can help manage psoriasis.

Anyone who notices new or worsening skin changes or who starts to have joint pain or other symptoms should see a doctor.

Learn more about the different types of psoriasis

Find out about these different types of psoriasis:

Read this article in Spanish.